Provider Demographics
NPI:1194743591
Name:HUNTER-BROWN, DEBORAH SOPHIA (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:SOPHIA
Last Name:HUNTER-BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 STEVENS AVE
Mailing Address - Street 2:SUITE 408
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2686
Mailing Address - Country:US
Mailing Address - Phone:914-663-1368
Mailing Address - Fax:914-663-1403
Practice Address - Street 1:105 STEVENS AVE
Practice Address - Street 2:SUITE 408
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2686
Practice Address - Country:US
Practice Address - Phone:914-663-1368
Practice Address - Fax:914-663-1403
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195354207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G19538Medicare UPIN
NY9X2671Medicare ID - Type Unspecified